Provider Demographics
NPI:1699241422
Name:KRYDER, LAURIE KAY
Entity type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:KAY
Last Name:KRYDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:INGEBORGSVAG 12
Mailing Address - Street 2:
Mailing Address - City:UPPLANDS VASBY
Mailing Address - State:STOCKHOLMS LAN
Mailing Address - Zip Code:19452
Mailing Address - Country:SE
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:DANDERYDS SJUKHUS
Practice Address - Street 2:MORBYGARDSVAGEN 88
Practice Address - City:DANDERYD
Practice Address - State:STOCKHOLMS LAN
Practice Address - Zip Code:18288
Practice Address - Country:SE
Practice Address - Phone:559-638-1706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-19
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9801363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA532959OtherREGISTERED NURSE
CA9801OtherNURSE PRACTITIONER CERTIFICATE